{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:25:34Z","timestamp":1782602734973,"version":"3.54.5"},"reference-count":39,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"2","license":[{"start":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T00:00:00Z","timestamp":1391212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:p>The incidence of clinically significant avascular necrosis (AVN) following medial open reduction of the dislocated hip in children with developmental dysplasia of the hip (DDH) remains unknown. We performed a systematic review of the literature to identify all clinical studies reporting the results of medial open reduction surgery. A total of 14 papers reporting 734 hips met the inclusion criteria. The mean follow-up was 10.9 years (2 to 28). The rate of clinically significant AVN (types 2 to 4) was 20% (149\/734). From these papers 221 hips in 174 children had sufficient information to permit more detailed analysis. The rate of AVN increased with the length of follow-up to 24% at skeletal maturity, with type 2 AVN predominating in hips after five years\u2019 follow-up. The presence of AVN resulted in a higher incidence of an unsatisfactory outcome at skeletal maturity (55% vs 20% in hips with no AVN; p &lt; 0.001). A higher rate of AVN was identified when surgery was performed in children aged &lt; 12 months, and when hips were immobilised in \u2265 60\u00b0of abduction post-operatively. Multivariate analysis showed that younger age at operation, need for further surgery and post-operative hip abduction of \u2265 60\u00b0 increased the risk of the development of clinically significant AVN.<\/jats:p><jats:p>Cite this article: Bone Joint J 2014;96-B:279\u201386.<\/jats:p>","DOI":"10.1302\/0301-620x.96b2.32361","type":"journal-article","created":{"date-parts":[[2014,2,3]],"date-time":"2014-02-03T10:09:09Z","timestamp":1391422149000},"page":"279-286","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":60,"title":["The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip"],"prefix":"10.1302","volume":"96-B","author":[{"given":"R. O. 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